Chain of custody record, Westchester County Lab, Oct 2001

NYC 9/11 Public Portal Document

IL ENVIRONMENTAL SERVICES SAMPLE SUBMISSION FORM WESTCHESTER COUNTY LABORATORIES AND RESEARCH 4 2 Dana Road, Valhalla, New York 10595 (914) 593-5575 NYS-ELAP No. 10108 de/DateSet:________________ ___ Form A-70 (rev. 1/96) Sample lype(cicle one): , S-6 7627, 22422 (1 Potable - 3. Non-Potable Treated Bottle #‘s: P 7036, <7s, 7 fa 7 2. Non-Potable 4. Other __________________ .yes Chain of Custody? no *929,$64 Time/Date Collected: o/4/0t ' 1322 Comments: Collected By: S, Al-a • Agency Code: _ Source ID:. Type Descriptor: Collected From: Bill to: Location’s/Individual’s Name. &012) Name/Company Street_________________ _ Street__________ City/St/Zip_______________ City/St/Zip_______ Identification of Source. • 8 Phone#:_ -Fax #: Collection Point 3 So Se . 30/3 CA, CH, BI? Check#: Amounts

ORGANIC POTABLE ANALYSES ORGANIC NONPOTABLE/SOLID ANALYSES

24377 BACTERIOLOGICAL ANALYSES _______ 4s Lab #: (circle tests)' a,2% ' • (circle tests) 1. Heterotrophic Plate 1. Trihale lomethanes (§24) * 1. Purgeable Halocarbons (624/8260) Count (hemodialysis & all others) 2. Coliform P/A (public supplies) 3. Coliform MPN (priv well, raw, stp) 3 Volatile Halocarbons (524) Volatile Aromatics (524) 4. Total Trihalomethane Potential (510) 2. Purgeable Aromatics (624/8260) Acrolein & Acrylonitrile (624) 3. 4. Phthalates (606/8060) 4. Fecal Coliform (all samples) 5. Microextractables (504) Organochlorine Pesticides (608/8080) 5. 5. Microscopic 6. Pesticides (507) 6. PCB’s (Arochlors) (608/8080) 6. Macroscopic ( Pesticides/PCB screen (508) 7. Herbicides (SM-18/6640; 8151) 7. API 8. PCB as Decachlorobiphenyl (508A) 8. Other Pesticides (SM-18/6630) her: *_______________ 9..Herbicides (515) 9. Petroleum Hydrocarbon Scan (310-13) (10, Pesticides (525) 10. Glycols in Water Refrigerated? yes no 11. Carbamate Pesticides (531) 11. Acid Extractables (625/8270) 12. Glyphosate (547) 12, Base Neutral Extractables (625/8270) Chlorinated?: yes no 13. Diquat (549) 13/GC/MS Unknown Scan 14. Chlorination Disinfection Byproducts (551) 14. Purgeable Halocarbons (DEF) Free Chlorine Res:. .mg/L 15. Haloacetic Acids (552) 15. Purgeable Aromatics (DEF) 16. Other Pesticides (SM-18/6630) 16. Pesticides (DEF) Total Chlorine Res: .mg/L 17. Petroleum/Hydrocarbon Scan (310-13) 17. PCB’s (Arochlors) (DEF)

pH. 1 > —' I •' INORGANIC ANALYSES REQUESTED - Lab#:. a f , (circle tests) 1. Color 20. Acidity 39. Aluminum 59. Potassium 2. T urbidity 21. Alkalinity, as CaCO3 40. Antimony 60. Selenium 3. pH 22. Bromide 41. Arsenic 61. Silver 4. Conductivity 23. Bromate/Chlorate/Chlorite 42. Barium 62. Sodium 5. Corrosivity (temp: °C) 24. Chloride 43. Beryllium 63. Thallium 6. BOD (5 day) 25. Cyanide 44. Boron 64. Vanadium 7. Soluble BOD (5 day) 26. Fluoride 45. Cadmium 65. Zinc__________ 8. Carbonaceous BOD (5 day) 27. Hardness, Total as CaCO3 46. Calcium, as CaCO3 CLP 9. Chemical Oxygen Demand 28. Nitrogen, Ammonia as N 47. Calcium, Ca*2 66. Metals/CN 10. Dissolved Oxygen 29. Nitrogen, Nitrate as N 48. Chromium, Total 67. Volatiles 11. Total Organic Carbon 30. Nitrogen, Nitrite as N 49. Chromium, Hexavalent 68. Semi-volatiles 12. Total Organic Halides 31. Nitrogen, Total Kjeldahl as N 50. Cobalt 69. Pesticides/PCB’s 13. Solids, Percent (%) 32. Oil and Grease 51. Copper 70. Disk Deliverables

ds iolids. Settleable 5iolids. Suspended 16. Solids, Total 33. Phenol 34. Phosphorus. Total as P 35. Phosphorus, Ortho as P 52. Iron 53. Lead 54. Magnesium TCLP 71. TCLP-Metals 72. TCLP-Pesticides 17. Solids, Total Dissolved 36. Sulfates 55. Manganese 73. TCLP-Herbicides 18. Solids. Total Volatile 37. Surfactants 56. Mercury 74. TCLP-Volatiles 19. Other:_____________ 38. UV254 57. Molybdenum 75. TCLP-BNA’s 58. Nickel

NYC-WTC_000027359